‘Inappropriate’ attenders to the Adult Emergency Department – A Critical Review

Lloyd-Jones, Angharad (2012) ‘Inappropriate’ attenders to the Adult Emergency Department – A Critical Review. [Dissertation (University of Nottingham only)] (Unpublished)

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Background: The Department of Health (DoH) emphasise the increased attendance

rates to the Emergency Department (ED) over the last decade from 14,044,018 in 2001-

2 (DoH, 2002) up to 21,342,543 in 2010-11 (DoH, 2010-11). Ainsworth (2008)

identified that annually up to 14 million attenders could have been treated by their

General Practitioner which coincides with Lee, Hazlett, Chow, Lau, Kam, Wong & Wong’s

(2003) suggestion that ‘inappropriate’ attenders are the cause of the increased

attendance rates. The literature is heavily criticised for the lack of definition and this is

respective in society illustrated through the increased attendance rates.

Aims: This study aims to critically review literature on ‘inappropriate’ adult attenders to

the Emergency Department.

Method: A critical review was used, reviewing 24 literature articles from ScienceDirect,

CINAHL, Medline and Embase using the keywords: “Emergency Service, Hospital/”,

“Emergency Medical Services/”, “Emergency Department.mp”, “Inappropriate.mp”,

“Primary Care.mp or Primary Health Care/”.

Findings: A lack of consistency between definitions of ‘inappropriateness’ to the ED was

found from the literature, leading to a vast discrepancy between definitions generated by

healthcare professional’s opinions and patients’. The role of the ED was found to relate to

functionality through name, suggesting that society is unaware of the role of the ED. The

reasons patients attend ED are variable, complex and consider health seeking behaviour

from a psychology approach.


Conclusion: The review found that the definition of ‘inappropriate attendance’ is elusive

and therefore open for interpretation by staff and patients. The use of personal opinions

as a definition has created a vast discrepancy between staff and patients’, leading to

‘blame’ and ‘labelling’ of patients.

Item Type: Dissertation (University of Nottingham only)
Depositing User: EP, Services
Date Deposited: 21 Nov 2013 14:53
Last Modified: 26 Oct 2016 19:36
URI: http://eprints.nottingham.ac.uk/id/eprint/26944

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